Pre-licensing visit·August 29, 2025

On 8/29/2025, Licensing Program Analyst, Arvin Villanueva (LPA) arrived unannounced at this facility to conduct pre-licensing inspection. LPA met initially met with staff on duty (S1) and explained the purpose of the visit. The Licensee, Cleopatra Gardiner, was notified to the visit. Per Licensee, she is unavailable at this time and will send her Administrator, Moria Gaunavou (AD), to assist with this pre-licensing. At around 11AM, AD arrived. Overview : Facility is a one-story home located in a residential neighborhood. Facility will be licensed to serve up to 6 elderly residents. Initial Observation: Upon arrival LPA was greeted by staff on duty (S1). Present during this visit were 4 residents in care, with one staff on duty (S1). 1 resident was in the second living room area, and 3 resident were in their bedroom. Room temperature was at 72 degrees Fahrenheit upon arrival. Physical Inspection : Areas inspected include, but not limited to, the kitchen, resident bedrooms, resident bathrooms, living and dining room and outdoor areas. LPA inspected 6 resident bedrooms. Based on the review of Fire Safety Inspection (STD850), Bedrooms #1 through $4 are currently occupied; Bedrooms #6 is currently vacant; Bedroom #5 was approved for non-ambulatory resident. However, Bedroom #5 is currently being utilized as a staff room. Further inspection of Bedroom #5, LPA did not observe the room to have any windows; LPA did not observe a closet; LPA observed the staff bed to be barely fitting the room, causing the door to not open all the way. LPA contacted the Fire Inspector via phone to verify/confirm the accuracy of the STD850 report. LPA measured the hot water temperature in the 3 of 3 bathrooms to be between 113 to 116 degrees Fahrenheit. All resident bathrooms were observed to be in good repair at this time. The garage is locked and not accessible to residents in care. Fire extinguisher was observed at the medication area, leading to the dining area; and it was last inspected on 1/8/2025. Smoke and carbon monoxide detectors were observed throughout, tested and found operable at this time. In the kitchen area, LPA observed at least seven day non-perishable and two day perishable food supplies. Kitchen refrigerator and freezer were maintained at regulatory temperatures. Medication cabinet was observed to be locked and not accessible to residents in care. Toxic materials, cleaning supplies, sharp objects and other dangerous items were observed to be in locked storage. Outdoor area was inspected. LPA observed outdoor furniture for resident use. Emergency walkways were observed to be unobstructed. Facility has one exit gate and was observed to be in good condition at this time. The fence at the right side of the facility, part of it was observed to be wobbling. THE FOLLOWING ADVISORIES WERE PROVIDED TO ADMINISTRATOR: REPAIR FENCE ON THE RIGHT SIDE OF THE FACILITY WAS OBSERVED TO BE WOBBLY REPAIR DOOR THAT EXITS TO THE BACKYARD NEEDS REPAIR - BOTTOM PART IS COVERED WITH TAPE. CLEAN/ORGANIZE THE GARAGE. PLACE A LOCK ON THE CLOSET THAT STORE THE WATER HEATER. ENSURE ALL STAFF FILES, INCLUDING ADMIN , ARE COMPLETE AND IN THE FACILITY AVAILABLE FOR REVIEW AT ANY TIME. ENSURE ALL RESIDENT RECORDS ARE UPDATED TO THE NEW LICENSE. Component III was conducted with AD. Based on the today's inspection, this Pre-Licensing is on hold and will require a continuation. LPA is waiting for Fire Inspector to verify/confirm the status of Bedroom #5. Exit interview was conducted and a copy of the report was provided upon exit.